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794) A 37-year-old woman presented to the emergency department with a 3-week history of severe headaches and two episodes of seizures. She is a recent immigrant from a rural area of Mexico and was in her usual state of good health until this presentation. Cultures and radiologic examinations were obtained. Computed tomography demonstrated several ring-enhancing cerebral calcifications. Subsequent serologic testing confirmed the diagnosis. Which one of the following is the most likely etiologic agent in this case?

Nocardia asteroides complex. Mixed anaerobic bacterial infection. Streptococcus mitis. Taenia solium. Cryptococcus neoformans.

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• Taenia solium taeniasis is acquired through ingesting undercooked infected pork, which contains cysticerci. Patients are often asymptomatic and may pass proglottids or, more rarely, eggs in their stool.

• Cysticercosis is acquired through ingesting T. solium eggs, which are shed in the feces of a human tapeworm carrier. Oncospheres hatch in the intestine and migrate to striated muscles and other tissues, including the brain, which results in neurocysticercosis.

• Examination of gravid proglottids can help differentiate T. solium from Taenia saginata (beef tapeworm). India ink is injected into the proglottids to observe the uterine branches. T. solium has 7 to 13 branches, whereas T. saginata has 15 to 20.

• Taenia eggs are difficult to distinguish from each other. Both T. solium and T. saginata eggs are round, yellow-brown, and thick shelled.

• For neurocysticercosis, surgical removal of the cysticerci is preferred and is often accompanied by treatment with praziquantel or niclosamide.

Garcia HH, DelBrutto, OH Nash TE, et al: New concepts in the diagnosis and management of neurocysticercosis (Taenia solium., Am J Trop Med Hyg 2005;72:3–9.

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Clinical Pathology: Microbiology

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